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Topic: Philosophy
April 11, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

Scientists now have the capability of changing the world. Literally. A prominent researcher observed in a 2011 Science article that "our genome engineering technologies treat the chromosome as an editable and evolvable template". The advent of such technologies is disturbing from many points of view.

Until very recently scientific research contributed to the advancement of knowledge about the world around us without simultaneously creating tools for altering the characteristics and parameters of that world. None of these activities threatened the integrity of the biosphere — namely, that of planet earth. The ability to do so should give all of us, primarily scientists, pause, but they do not. As Hans Jonas observed, the deeds of biological engineering are irrevocable.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

January 27, 2012 | Posted By Wayne Shelton, PhD

For most of the past 20 years I have had the privilege of talking with and learning from medical students in small group discussions. As medical students leave the classrooms of the first and second year and transition into the third year, they confront a new reality: they are now actually encountering patients directly for the first time and are working with physicians in the daily care of patients. The more encounters they have with patients and their families and with their clinical mentors, the more stories they have to tell, which often lead to vexing questions that shed light on many of the problems of our health care system in the United States. 

One of the common themes throughout each year is the growing disenchantment with primary care, for a variety of reasons. Most of the students are assigned at some point to a clinical mentor who is a practicing internist seeing many patients each day in a primary care setting. Students often present cases of patients with complex medical and psychosocial issues that require interaction with and support from the physician. Not infrequently do we hear accounts of how patient non-compliance is a barrier to a constructive outcome. The idea of seeing patients over time with the same medical problems, while not heeding medical advice, strikes many students as a frustrating aspect of primary care. Also the students talk of these same physicians continuing to work into the evening, doing mountains of administrative work because of multiple insurance forms to complete. 

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

November 3, 2011 | Posted By Michael Brannigan, PhD

During a high school cross-country race last month in Minnesota, Andover's Josh Ripley stopped to aid injured opponent Mark Paulauskas from Lakeville South, carried him more than 100 yards to medical help and then jumped back into the race. As Ripley came to the finish line 211th in a field of 261, the Lakeville squad greeted him with cheers (http://tinyurl.com/3bjzhsv).

If "Winning isn't everything; it's the only thing," Ridley failed miserably. We worship winners and assign the losers to public recognition's dustbin.

Yet did you know that Vince Lombardi, just before he died, regretted his one-liner?

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

 

October 17, 2011 | Posted By Michael Brannigan, PhD

Georgia Holland, a volunteer from Christ Church United Methodist of Troy, and Miriam Santiago, who lives in a trailer home on First Avenue, carry away debris from the home from the flooding of Tropical Storm Irene. Sept. 3, 2011. (Brian Nearing/Times Union)

Shinichi Hashiura and his wife, Toyoko, were inseparable. They were working alongside each other in their barbershop-salon when Japan's 3/11 Tohoku earthquake and tsunami flattened their village, crushing Toyoko as she tried to aid an elderly neighbor.

Just as his wife often hairdressed for the aged in their homes, the Daily Yomiuri reports that 62-year-old Hashiura now gives free haircuts to countless occupants in shelters throughout the blistered region.

Calamity is a cruel teacher. It offers an invaluable lesson in these fractured times -- the meaning and importance of community. Yet today we cheapen the term, using "community" loosely, applying it to groups, organizations and collectivities as in academic community, online community and business community.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

August 3, 2011 | Posted By Michael Brannigan, PhD

What comes to mind when we think of ethics?

Problem-solving? Decision-making? Pondering, "What is the right thing to do"? "How am I to act"?

Herein lies the persistent hazard for ethics, particularly as an institutionalized field: its near-obsession with "the problem."

To explain, I first offer two senses of ethics. First, it is the formal philosophy and theology discipline that I've been trained in, together with other humanities and science courses. Second, it is an applied field, like my work in health care ethics, and more thoroughly institutionalized.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

 

July 27, 2011 | Posted By Ricki Lewis, PhD

Like Alvy Singer, Woody Allen’s character in Annie Hall, I’m obsessed with books about the end of humanity, which sometimes involves the end of the world, and sometimes just that of Homo sapiens. Midsummer is a good time to contemplate how bioethics would come into play in such unlikely scenarios, which raise issues of utilitarianism, justice, paternalism, death and dying, and misuse of technology. 

I prefer the human-wrought disasters to the more celestial imagined ends, such as the film “Asteroid”, which was so bad that my husband dubbed it “Hemorrhoid”. My favorite, after many years of wallowing in these depressing depictions, is "Swan Song," by Robert McCammon, in which survivors of a nuclear holocaust stagger about, drinking wolf’s blood to avert starvation. I can still picture, practically smell, when 6-year-old Swan picks the first apple to grow after a nuclear winter. Another favorite is “The Road,” in which Cormac McCarthy recounts the journey of a father and son as they traverse post-apocalyptic terrain, searching for others. What led to the destruction of society? How does it rebuild? Is a messiah, like Swan, essential?

I also savor novels that alter the human life cycle, tweaking age cohorts. “The Children of Men,” an excellent book by P.D. James and a terrible film, envisions a world with no more children. Time ticks down to the inevitable end of our species, with the drama centering around a pregnant woman. That’s a scenario that would welcome reproductive cloning!

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 21, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Many are not convinced the glittering promise of genetic manipulation implies the presence of a pot of gold. Science often moves faster than moral understanding. For some, the gift of life is paramount. Children should be appreciated as the gifts they are. If we are seduced by the sirens of science, the breakdown of society will ensue and social solidarity will dissolve.

There is a wider benefit. Good genes over time create fitter humans — the entire gene pool could become optimized over a handful of generations. Certainly, such humans would have genomes qualitatively and quantitatively different from the genomes of 10,000 years ago. But over evolutionary time, viruses infiltrate our nuclei and update our 3 billion base pairs. Again, systematization of this "creation"-based process could provide great benefit.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 7, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Frankenstein, written by Mary Shelley in 1818, is as compelling and thought-provoking in 2011 as when the novel appeared almost 200 years ago. Shelley subtitled her opus The Modern Prometheus. Dr. Victor Frankenstein, although certainly no god, was a brilliant scientist who paid bitterly for the fruits of his genius. His loved ones were tragically murdered by his inhuman creation and he was doomed to suffer relentlessly for his deeds, as was Prometheus.

One possible conclusion from Shelley’s cautionary tale is that science should never proceed unchecked. Science always needs to be constrained by moral principles and its activities need to be referenced against potential harms. Frankenstein’s hubris blinded him to the likely untoward outcomes of his research. He was only focused on the task he had set himself. He gave no thought to what such a creature would think or how it would act. He certainly never considered potential consequences to others that would flow from the existence of such a creation.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

June 10, 2011 | Posted By Posted By David Lemberg, M.S., D.C.
Dr. Adina Roskies
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Dr. Adina Roskies is Associate Professor in the Department of Philosophy at Dartmouth College. Her areas of specialization are Philosophy of Science, Philosophy of Cognitive Science, and Philosophy of Mind.

Dr. Roskies was Project Fellow on the MacArthur Project in Law and Neuroscience from 2007 through 2010. Her recent publications include Neuroscientific challenges to free will and responsibility, published in Trends in Cognitive Sciences; “Neuroethics beyond genethics”, published in EMBO Reports; and Neuroimaging and inferential distance, published in Neuroethics.

In our 5-3-2011 BIOETHICS TODAY conversation, Dr. Roskies discusses

  • Free will and determinism
  • Compatibilism and incompatibilism
  • Neuroscience–the brain as a mechanism
  • Can the brain cause behavior?
  • Neuroscience, determinism, and moral responsibility
  • Neuroscience and the law

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

May 16, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

A bioethicist, obviously, is a person who practices bioethics. But what does this entail? On one hand, bioethics could be narrowly construed as focusing on medical ethics. A broader perspective exists, based on an expansion of bioethics to "biological ethics". Both frameworks, the narrow and the broad, are eminently valid and neither needs to exclude the other.

The need for bioethics and bioethicists is greater now than ever. Bioethicists are able to offer substantial value to communities at all levels, ranging from the level of the individual (a community of one) to the level of the planet (a global community), conceived as an intricately interwoven biosphere.

Let's get specific. What are the kinds of things that bioethicists do?

A bioethicist could be a member of a hospital staff and function as a clinical consultant. Bioethics consultations facilitate patient care in

  • Determining capacity/competency related to making an informed choice
  • End-of-life planning and decision making
  • Determinations of medical futility
  • Assisting families in making decisions regarding withdrawal of life support

A bioethicist may also function as an ombudsman for the patient and family, helping to establish ongoing clear and effective communication among all concerned parties. Depending on the context and the need, she would consult with the patient, the patient's family, medical staff, and administrative personnel.

In such a practice, the bioethicist is applying daily the principles of autonomy, beneficence, nonmaleficence, and justice. He is engaged in rewarding, exciting, ever-changing work with real people grappling with real, life-impacting challenges. Every day presents new opportunities to help make a meaningful difference at an individual, family, and community level.

And, much more is possible. Bioethics need not be restricted to the medical arena. Looking beyond the world of hospital practice, there are an abundance of opportunities for the bioethicist to paint with a broader brush.

For example, what are the responsibilities and accountabilities of global pharmaceutical companies? Almost 3 billion people worldwide live on less than $2 per day. These persons do not have the wherewithal to afford life-saving medications. The pharmaceutical giants are very glad to conduct clinical trials in developing nations where the costs of doing business are substantially lower than in their home countries. But these companies do not reciprocate and provide drugs at cost to indigent communities and societies. Bioethicists can help create policies focusing on distributive justice to be implemented by multinational pharmaceutical corporations.

The fields of wildlife conservation, sustainability, and renewable resources could all be enhanced by bioethics-informed policy. Human health and welfare depend not only on our interactions with each other. If bioethics intends to support the thriving of humans, it necessarily intends to support the thriving of redwood forests, coral reefs, butterflies and bumblebees, songbirds, and tuna and salmon. Natural capital and ecological services are valued at many trillions of dollars annually. Each of the four iconic bioethical principles is intimately related to maintenance and support of our natural world.

Bioethicists may work in universities, hospitals, all levels of government, policy institutes, and NGOs. Importantly, bioethicists could also work in corporations. What sort of corporation—national or multinational—would hire a bioethicist? If the corporation’s sole interest is its bottom line, i.e., profit and shareholder dividends, bioethics would most likely not fit into its strategy.

But a corporation’s board could have a different vision. Such a board could understand that the organization's long-range welfare is closely tied to the global economy, which is closely tied to the welfare and productivity of all populations, which is closely tied to ensuring the ongoing viability of environmental resources and ecological services. Such a corporation’s goals would be greatly furthered and assisted by having bioethicists on staff.

Too often, an observer of the field gets the impression that bioethics is primarily concerned with parsing ever finer notions of patient autonomy. On this view, it is IRBs rather than angels which are dancing on the head of a pin. Switching metaphors, such navel-gazing helps no one, except to provide meager support for struggling academic careers.

Bioethics is not this. Bioethics is the broad end of the funnel. Almost 50 years ago in his famous book Love and Will, the American psychologist Rollo May described the transitional nature of then-modern 1960s society. Those transitional qualities have persisted rather than resolved. The global economy is in crisis. Global climate change is apparent. Environmental resources and species diversity are at great risk. Health care, as such, is unrecognizable compared to 50 years ago, and not in a good way.

Bioethics and bioethicists can provide unique perspectives and original solutions in helping resolve the diverse challenges facing not only the United States but our global society. Bioethics and bioethicists can participate fully and become critical assets in humanity's search for meaning, self-realization, and discovery of arete.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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ABOUT BIOETHICS TODAY
BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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